Health
Lifestyle changes reduce the risk of T2D in women with a history of gestational diabetes.Latest news for doctors, nurses and pharmacists
Each time an optimal modifiable factor is added among women with a history of gestational diabetes (GDM) Significant Contribution to Type 2 Reduction
Diabetes (T2D) risk, recent studies suggest. These associations are also found in overweight/obese individuals or individuals with increased genetic susceptibility to T2D.
“Participants who had optimal levels of all five modifiable factors after their first pregnancy had a greater than 90% lower risk of developing type 2 diabetes compared to those who had none. ‘ said the researchers.
This prospective cohort study included a total of 4,275 women with a history of GDM from the Nurses’ Health Study II, repeatedly measured weight and lifestyle factors, and followed them between 1991 and 2009.
Researchers assessed the following modifiable risk factors: [BMI] <25.0kg/m2), high-quality diet (top 2/5 modified alternative health diet index), regular exercise (≥150 minutes/week of moderate intensity or ≥75 minutes/week of vigorous intensity), moderate alcohol consumption consumption (5.0–14.9 g/day) and no current smoking.
Genetic susceptibility to type 2 diabetes was defined by a genetic risk score based on 59 single nucleotide polymorphisms associated with type 2 diabetes in a subset of participants (n = 1,372).
Of the participants, 924 developed T2D during a median follow-up of 27.9 years. Women with optimal levels of all five factors had more than 90% lower T2D than women without optimal levels of any of the risk factors. [BMJ 2022;378:e070312]
For women with 1, 2, 3, 4, and 5 optimal levels of modifiable factors, the hazard ratio (HR) for type 2 diabetes was 0.94 (95% confidence interval). [CI]0.59–1.49), 0.61 (95% CI, 0.38–0.96), 0.32 (95% CI, 0.20–0.51), 0.15 (95% CI, 0.09–0.26), and 0.08 (95% CI, 0.03–0.23) , respectively, compared with none (ptendency<0.001).
The benefit of having an optimal modifiable factor was also evident in overweight/obese participants or in participants with high genetic susceptibility (ptendency<0.001).
HR with optimal levels of four other risk factors in women with BMI ≥25 kg/m2 (n=2,227) was 0.40 (95% CI, 0.18–0.91). In genetically susceptible individuals, the HR for achieving four optimal factors was 0.11 (95% CI, 0.04–0.29). Of note, those with optimal levels of all five factors did not develop T2D events.
“Our findings are consistent with a subgroup analysis of women with a history of GDM (n=350) in a diabetes prevention programme, in which an intensive lifestyle regimen including dietary weight loss and increased physical activity was performed. The style intervention reduced the risk of T2D by 50% after 3 years of follow-up compared to placebo,” the researchers said. [J Clin Endocrinol Metab 2008;93:4774-4779]
“The latest findings from a major diabetes prevention program study support the long-term efficacy of lifestyle interventions to prevent T2D with 15 years of follow-up,” they added. [Lancet Diabetes Endocrinol 2015;3:866-875]
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